Background: Adherence to HIV/AIDS therapies has been an important health problem since the early 1980s when AZT was first prescribed as a treatment for HIV/AIDS and it became more important in 1995 with the advent of protease inhibitors. Non-adherence leads to ineffective treatments and the development of drug resistant strains of HIV, which contribute to higher AIDS rates. These rates are greater in low-literacy populations than high literacy ones due to factors ranging from shame to access to care. Methods: An intervention was developed to increase adherence to HIV/AIDS therapies among seropositive low-literacy populations of African-American women in Houston, Texas. A needs assessment was conducted using the PRECEDE model and 54 subjects were recruited for a formative evaluation. Results: The results indicated that five theoretical constructs: knowledge, perceived susceptibility, perceived severity, outcome expectations, and self-efficacy were important and changeable determinants of adherence. A cartoon book suitable for people with 2.9 years of education and 10-minute cassette tape were developed to change these determinants and increase adherence. The formative evaluation of the cartoon book and tape indicated that the content and structure were accurate, clear, realistic, readable, and that the materials would likely be used as intended. Conclusion: Innovative adherence interventions are needed to reach marginalized populations to decrease the incidence of AIDS and delay the time to death. Needs assessments provide a firm foundation for planning while formative evaluations maximize the likelihood that interventions will achieve the program goals.
Learning Objectives: List and describe three steps of formative evaluation. Define the acronym PRECEDE. List and describe five phases of the PRECEDE needs assessment model
Keywords: Adherence, Needs Assessment
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA